Written by Plaintiff Litigation Group PLLC
Although many people deal with health insurance claims on a regular basis, most of us only rarely have a homeowner, auto, life, liability or other kind of claim. Unless you’re in the insurance or legal industry, you’re unlikely to know the rules that apply to insurance claims. The insurance adjuster, on the other hand, knows the rules. Adjusters are trained to make you feel like everything is under control. Sometimes people who run into problems with their claims come to find out too late that there were warning signs all along. A lot of people have a vague feeling they might need legal help, but the process for finding a lawyer who knows the ins and outs of insurance seems really intimidating.
The purpose of this guide is to give you some tips as you consider whether you need to get legal help with your insurance claim.
No. 1. Most people don’t get lawyers.
In most cases, the claim is opened, the insurance company makes its decision, and the person making the claim lives with the company’s decision.
This isn’t necessarily a good thing. Insurance companies are motivated by profit, and sometimes adjusters are rewarded if they lower claims payments. If people are afraid to disagree or to push back on the insurance company—or if they don’t know their rights—then insurance companies know they can get away with paying less than they’re required to under the insurance policy. Multiply this over thousands or millions of claims a year, and the public can be robbed of millions of dollars of benefits.
No. 2. You’ve got important protections under the law.
Under Washington law, it’s the insurance company’s legal obligation to fully, fairly, and promptly investigate your claim. The law imposes timelines for that investigation to occur. Legal regulations don’t allow the insurance company to drag out the investigation. If an expert has to be hired to determine the extent of the damage, then it’s the insurance company’s job to hire that expert and make a determination about the amount of money you’re owed. The insurance company has a legal duty to explain your rights to you in a way that you can understand. It isn’t allowed to keep you in the dark. There are strict timelines for responding to your communications.